From source documents to a review the pharmacist can decide.
METHUVIA AI prepares the review in five steps. The pharmacist’s coverage decision comes after that preparation. It is not a sixth step of the software.
METHUVIA AI prepares the review. The pharmacist makes the final coverage decision.
Documents processed
The coverage policy, prior authorization request, and clinical chart notes are organized as the source material for the review.
Policy pathway identified
The applicable policy pathway is identified from the request, the indication, and the review type.
Clinical evidence evaluated
Chart notes are reviewed for evidence that relates to the policy requirements in front of the reviewer.
Policy requirements evaluated
Each applicable requirement is shown with a status and the source support available for it. Missing support is not filled in.
Review prepared
METHUVIA AI summarizes the case, shows criteria status and rationale, and surfaces an advisory recommendation.
After preparation
Pharmacist decision
A licensed pharmacist reviews that preparation and makes the final coverage decision. Approve, deny, and request-for-information actions stay with the pharmacist.